SEARCH

Commonwealth of Massachusetts v. Kathleen Sebelius, et al

Thank you for sharing!

Your article was successfully shared with the contacts you provided.

Before Lynch, Chief Judge, Boudin and Howard, Circuit Judges.

LYNCH, Chief Judge. The Commonwealth of Massachusetts, by the administrator of “MassHealth,” its state Medicaid program, appeals from a dismissal of its lawsuit against federal officials for failure to state a claim under Fed. R. Civ. P. 12(b)(6). The Commonwealth claims that the federal Centers for Medicare & Medicaid Services (CMS) and associated entities violated the federal Medicaid statute when they refused to allow the Commonwealth to recover reimbursement directly from CMS in four cases of “retroactive dual eligibility.”

In each of these four cases, an individual who received Massachusetts Medicaid funds to pay for medical services was later deemed retroactively eligible for federal Medicare funds for the period in which the individual received those services. The state is trying to secure reimbursement for its past Medicaid payments by directly petitioning the federal government for reimbursement rather than going back to the providers of services, whom the Medicare program clearly recognizes as appropriate claimants. This dispute is not over whether the Commonwealth should ultimately be reimbursed by Medicare, but whether it has chosen a permissible mechanism to recover reimbursement. Cf. Massachusetts v. United States, 522 F.3d 115, 129 n.8 (1st Cir. 2008).

More From ALM

Premium Subscription

With this subscription you will receive unlimited access to high quality, online, on-demand premium content from well-respected faculty in the legal industry. This is perfect for attorneys licensed in multiple jurisdictions or for attorneys that have fulfilled their CLE requirement but need to access resourceful information for their practice areas.
View Now

Our Team Account subscription service is for legal teams of four or more attorneys. Each attorney is granted unlimited access to high quality, on-demand premium content from well-respected faculty in the legal industry along with administrative access to easily manage CLE for the entire team.
View Now

Bundle Subscriptions

Gain access to some of the most knowledgeable and experienced attorneys with our 2 bundle options! Our Compliance bundles are curated by CLE Counselors and include current legal topics and challenges within the industry. Our second option allows you to build your bundle and strategically select the content that pertains to your needs. Both options are priced the same.
View Now

From Data to Decisions

Dynamically explore and compare data on law firms, companies, individual lawyers, and industry trends.

Exclusive Depth and Reach.

Law.com Compass includes access to our exclusive industry reports, combining the unmatched expertise of our analyst team with ALM’s deep bench of proprietary information to provide insights that can’t be found anywhere else.

Big Pictures and Fine Details

Law.com Compass delivers you the full scope of information, from the rankings of the Am Law 200 and NLJ 500 to intricate details and comparisons of firms’ financials, staffing, clients, news and events.

British Legal Awards 2024

November 27, 2024
London

Celebrating achievement, excellence, and innovation in the legal profession in the UK.

Learn More

GlobeSt. Healthcare Real Estate 2024

December 02, 2024 - December 03, 2024
Scottsdale, AZ

Join the industry's top owners, investors, developers, brokers and financiers for the real estate healthcare event of the year!

Learn More

ThinkAdvisor LUMINARIES Awards 2024

December 11, 2024
Las Vegas, NV

This event shines a spotlight on how individuals and firms are changing the investment advisory industry where it matters most.

Learn More

Attorney - Insurance Defense

Downtown NY property and casualty defense law firm seeks a Litigation Associate with 3+ years' experience to become a part of our team! You ...

Apply Now ›

Labor & Employment Counsel - New York, NY

Description: Fox Rothschild has an opening in the New York office for a Counsel in our renowned Labor & Employment Department, working w...

Apply Now ›

(NEW) ASSISTANT GENERAL COUNSEL WANTED FOR PRIVATELY HELD HEALTHCARE COMPANY (Oak Brook, IL)

Our client, a large, privately-owned healthcare company, has engaged us to find an Assistant General Counsel for their headquarters located ...

Apply Now ›